How accurately can direct and indirect inguinal hernias be distinguished?

An inguinal hernia was clinically diagnosed as direct or indirect by paired surgeons of 134 occasions. When compared with the findings at operation the hernia was correctly diagnosed in 60 of 78 observations when it was indirect and in 33 of 56 when it was direct. The level of accuracy does not warrant continuing the practice of attempting to distinguish one type of inguinal hernia from another.